微创小切口潜行神经通道扩大技术在腰椎间盘突出症手术治疗中的应用  

Application of Minimally Invasive Small Incision Associated with Sneaking Expansion of Neural Access in Lumbar Disc Herniation Surgery

作　　者：韩裕[1] 李庆奇[1] 吴友科[1] 李大志[1] 何先晓[1] 莫健超[1] 刘宝[1] 张玉宏 

机构地区：[1]广东肇庆医学高等专科学校附属医院骨科,肇庆526020 [2]山西榆次人民医院骨科,榆次030600

出　　处：《中国现代手术学杂志》2008年第5期353-355,共3页Chinese Journal of Modern Operative Surgery

基　　金：广东肇庆市科技创新计划项目(2008E322)

摘　　要：目的探讨应用微创小切口潜行神经通道扩大技术行腰椎间盘突出症髓核摘除、神经通道松解的手术方法及疗效。方法小切口组30例,采用微创小切口潜行神经通道扩大技术行经后路髓核摘除;对照组20例,行传统后路手术,两组均为单间隙腰椎间盘突出症病例,对其临床资料及随访结果进行病例对照研究。结果小切口组在出血量,手术时间、离床时间方面均优于对照组（P〈0.05）。两组均未出现严重并发症。均获随访,平均7.2（0.5-12）年。下腰椎术后疗效评定：小切口组优27例,良2例,可1例,优良率96.7%,对照组优16例,良2例,可2例,优率良90.0%,两组比较无差异（P〉0.05）。结论应用微创小切口潜行神经通道扩大技术治疗腰椎间盘突出症,手术操作简单、安全,可以在微创的前提下获得与传统手术相同的疗效,且并发症少,值得推广应用。Objective To study the methods and effects of lumbar disc herniation nucleus removing and neural access solution with minimally invasive small incision associated with sneaking expansion of the neural access. Methods Case control study was used retrospectively. In the study group, 30 patients received small incisions, nucleus removing and sneaking expansions of neural access via the posterior approach. And in the control group, 20 patients received traditional posterior surgery. All the 50 cases were single-interspace lumbar disc herniation. Results There was no severe complication occurred in both groups, but the clinical results in the study group were significantly better than those of the control group in the aspects of blood loss, operation time and leaving bed time（P 〈0.05）. All the patients were followed up for half to 12 years （ an average of 7.2 years）. The postoperative lower lumbar therapeutic effect evaluation showed excellent of 27, good of 2 and fair of 1 in the study group, and excellent of 16, good of 2 and fair of 2 in the control group （ P 〉 0. 05 ）. Conclusion Application of minimally invasive small incision associated with sneaking expansion of neural access is simple, safe and effective with little trauma and few complication in the lumbar disc herniation surgery.

关 键 词：椎间盘移位 神经通路 外科手术 微创性 

分 类 号：R687.3[医药卫生—骨科学]